If Atul Gawande had been better at being devious, the world might never have gotten "Being Mortal."

Gawande today is a Harvard professor, surgeon, author of best-sellers like "Being Mortal" and one of the pre-eminent thinkers in health care. But 25 years ago, he was a young staffer in the Clinton administration, a political appointee on leave from medical school trying to help lead the White House's health reform effort. It didn't always go well — partly because Gawande didn't know how to handle Washington's sharp elbows.

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"I get to do the briefing in the Roosevelt Room and then have people who wanted me out of there leak to the press … 'He's just a medical student doing the briefing,' or other stuff," Gawande told POLITICO's "Pulse Check" podcast. "I'd no longer be running the briefing. I'd be kicked out of the briefing."

It was a frustrating lesson about working in politics. "Being right about policy is not all that matters," Gawande said.

Another lesson was that being a policy adviser — even a fast-rising one who worked on both the Clinton health plan and another prominent proposal authored by Rep. Jim Cooper (D-Tenn.) — wasn't in his DNA. "I was not ready to … have my future dependent on the careers of politicians," Gawande said. "I wanted my own voice."

On the podcast, Gawande noted that his friend and peer Sylvia Mathews Burwell — the two overlapped as Rhodes scholars and on the Clinton campaign — charted a very different Washington path, rising through the Clinton and Obama administrations before ultimately becoming HHS secretary.

"She understood there were ups and downs," Gawande said. "She found ways to be effective. ... I needed to learn how to have that kind of patience."

Now a high-profile author of four award-winning books, Gawande can more carefully pick his spots. And in his role as a researcher and policy expert, Gawande said he speaks with both Democrat and Republican senators — "I'm not gonna name names, because they asked me not to," he demurred — although he observed a difference in how they craft policy.

"With the Democrats, it's often that the discussion's all about, 'What's the policy I want to go for, and how do I get the public there?'" according to Gawande. In contrast, he said that even Republicans who privately agreed with certain proposals said they had to publicly disagree so they matched the position of their voters. "As one said to me, 'That's fine, but everybody running against me is to the right of Attila the Hun, so that's not a direction I can go,'" Gawande recounted.

But as a writer and researcher, "I hardly come to Washington," Gawande said. "The reason why is because I don't think the story is in Washington." He pointed to his award-winning 2009 story about incentives in health care, "The Cost Conundrum," as one example of that dynamic.

"I was doing the story about McAllen, Texas, being the most expensive place for Medicare in the United States," Gawande said. "That required no time talking to people in Washington."

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"It's always a temptation, and I've been asked at various points," Gawande said on the podcast. "But what I learned … is that what I'm good at is not the same as what people who are good at leading agencies or running for office are really good at."

"Bill Clinton loved a good fight, he loved a good enemy," Gawande added. "I hate a fight. I hate people who hate me."